Ghanaian women doctors champion contraception rights

On May 28, every year, the world commemorates the Day of Action for Women’s Health. The 2013 event was marked by a specific call to action and was based on the theme: “Contraception is a Human Right.” In Ghana, the Medical Women’s Association of Ghana (MWAG) has embarked upon a series of health promotion and advocacy initiatives to promote contraceptive use while highlighting the various barriers that prevent Ghanaian women from fully accessing care.
“The Day of Action for Women’s Health is important for women doctors because it is a reminder that empathy is not enough. Women doctors need to translate that empathy into better health care for women in whichever specialty they practise. The Medical Women’s Association of Ghana (MWAG) exists to bring to the attention of the medical community, and the public at large, to the health interventions that directly improve the quality of life of women,” said Dr Charlotte Gardiner, Secretary to the Association.  

According to Ghana’s 2008 Demographic and Health Survey, over 98 per cent of men and women knew at least one method of contraception. This knowledge was, however, at its lowest among poor and rural women. As was often the case, the gap between knowledge and use was huge, with only 50 per cent of women reporting to have used one method at some time.

Forty-two per cent used a modern method, commonly male condom, and 25 per cent used a natural method, commonly rhythm method. It was also noted that although contraceptive use was higher among men than women, more men used traditional methods like rhythm and withdrawal. Further, women with some secondary education have been found to be twice as likely to use contraception compared to women with no education. The Northern Region had the lowest prevalence rate at 6 per cent.

If natural methods of contraception represent the simplest most available forms, then ignorance in this area should be a bottleneck. While knowing safe periods of a woman’s ovulatory cycle is fundamental to these natural methods, as many as 52 per cent of women wrongly believed that the fertile period was right after a woman’s period had ended, or did not know which period of the ovulatory cycle represented safe periods and which represented a woman’s most fertile period or believed that there was no specific time in a woman’s cycle when she was most likely to get pregnant after sex.

Typically, health workers teach that if the first day of bleeding represents the first day of the ovulatory cycle, and if one should continue to count the days from there, days twelve to sixteen represent the most fertile periods of a woman’s cycle during which chances of pregnancy are greatly enhanced.

One of MWAG’s objectives is to tackle the underlying reasons for non/limited use. Among the reasons why women do not intend to use family planning are fears of the side effects, personal opposition to family planning, opposition from partners, concerns that some methods may lead to reduced fertility and the desire for more children. According to the DHS, “Only small proportions of women cited lack of knowledge of methods, lack of access or cost as the main reason they do not intend to use family planning.”

It is into these reasons that MWAG has sought to strategically integrate its interventions. As Dr Gardiner explained, “This day, May 28, 2013 should be important to Ghanaian women because national statistics show that while the use of contraceptives is very low, unmet need for family planning is high and unsafe abortion (a result of unwanted pregnancy and inadequate health care) is a major cause of maternal mortality. 

Belief systems (religious and traditional) are the basis of stigma attached to the use of contraceptives in some communities in Ghana. The 2013 call to action, “Contraception is a Human Right,” confronts these reservations couples have regarding the use of contraceptives and promotes evidence- based encouragement to women to overcome these fears and take the necessary action to meet their reproductive choices.”

To mark the day, the Medical Women’s Association of Ghana organised interactive sessions with its members in Accra and Kumasi. During the sessions, women doctors were encouraged to integrate counseling on contraceptive use in their consultations. Additionally, women doctors were advised to use the opportunity to increase their knowledge about contraceptives and to make a renewed commitment to ensure that their clients were motivated and enabled to access appropriate contraceptive care for improved care.

Article by Sodzi Sodzi-Tettey
[email protected]
www.sodzisodzi.com